When Diabetes Care Becomes a Conversation| Reflections from the Chivhu Diabetes Workshop

Group Photo | Chivhu General Hospital, Zimbabwe

There was something different about the Chivhu diabetes workshop.

We did not walk into Chivhu General Hospital with a long list of presentations and expect people to sit, listen and leave.

We started by asking questions:

Ambassador Tinotenda Dzikiti| Coordinator

• We asked people living with diabetes: What do you want to learn? What do you need clarity on? What is difficult for you?
• We asked caregivers: What do you need to understand better so you can support your families at home?
• And we asked healthcare workers: What challenges are you facing when caring for people living with diabetes?

Those questions shaped the day.

The result was a workshop that was practical, honest, interactive and, most importantly, centred around the people who actually live with diabetes and those who care for them.

This workshop was part of the Peer-Led Diabetes Empowerment Project, supported by Sanofi’s Global Health Unit, in partnership with Lili Grace Foundation Ltd, and hosted at Chivhu General Hospital with the support of the Ministry of Health and Child Care.

More than a workshop

For us, a diabetes workshop should never be about filling a room, making presentations and taking photographs.

People need to leave with something.

They need to understand their condition better. They need to know what to do when something goes wrong. They need to feel confident asking questions. Caregivers need to know how to support without overwhelming. Healthcare workers need practical tools that they can take back into the hospital.

And people living with diabetes need to know that their diagnosis does not mean their life has ended.

A health facility should not only be a place where someone receives a diagnosis or treatment. It should also be a place that gives people hope to go back and do life again.

That thinking shaped Chivhu.

Three conversations happening at once

One of the things that made the workshop special was the use of parallel breakout sessions.

Instead of keeping everyone in one room for the entire programme, participants were separated into three groups so they could have more open and relevant conversations.

Parents and caregivers: “Supporting the Journey”

Led by Ruvimbo Danda, Registered Dietitian, and Walter Beta, Clinical Psychologist, this group focused on what happens after the person leaves the hospital.

Caregiver breakout session

How do you support a young person living with diabetes at home?

How do you talk about food without turning every meal into an argument?

How do you support emotional wellbeing?

How do you know when your child needs encouragement, when they need space and when they need professional help?

These were not theoretical conversations. Caregivers shared real experiences from their homes, asked questions and listened to one another.

The message was not about controlling someone with diabetes.

It was about supporting the journey.

People living with diabetes: “Living, Learning & Sharing”

Lived Experience breakout session

In another room, people living with diabetes had their own conversation.

Rufaro Gororo-Norumedzo, Silent Manyere and Tinotenda Dzikiti led a peer discussion that allowed participants to speak about what it actually feels like to live with diabetes.

• School.
• Work.
• Family.
• Stigma.
• Technology.
• Financial constraints
• Fear.

The things that happen when nobody else is watching.

There was no podium and no complicated presentation.

Just people talking to people.

Sometimes, the most powerful thing you can tell someone living with diabetes is not something from a textbook.

It is:

“I understand. I have been there too.”

And that is the strength of lived experience.

Healthcare professionals: “DKA: Recognise, Respond, Refer”

Healthcare workers had their own focused clinical session led by Dr Prisca Mureriwa-Matyanga, Paediatric Endocrinologist.

HCP Capacity Building breakout session

The 30-minute session focused on recognising Diabetic Ketoacidosis early, immediate management principles, knowing when to escalate or refer, and some of the practical realities of managing DKA within a hospital setting.

It was another reminder that diabetes education is not only for people living with diabetes.

Healthcare workers also need continuous opportunities to refresh knowledge, discuss difficult cases and strengthen their confidence in managing diabetes emergencies.

Learning diabetes beyond the numbers

Dr Mureriwa-Matyanga helped participants go back to the basics — understanding Type 1 and Type 2 diabetes, recognising common symptoms and understanding diagnosis.

But the conversation quickly moved beyond the numbers.

Diabetes management involves insulin where required, food, physical activity, monitoring blood glucose, hypoglycaemia management, sick-day care and mental wellbeing.

• Because diabetes does not stop at the hospital door.
• The person still has to manage it when they get home.
• They still have to make decisions at school.
• They still have to manage it at work.
• They still have to navigate family expectations, food, finances and everything else that life brings.

Food should not make someone feel different

Registered Dietician| Ruvimbo Danda

Registered Dietitian Ruvimbo Danda brought nutrition down to the level of everyday family life.

One of the important messages was that there is no need to create a completely separate world of food for someone living with diabetes.

If the family is eating meat, vegetables or other foods, the person living with diabetes should not automatically be excluded from the family meal.

The conversation focused instead on portions, balance, food choices and understanding how different foods affect blood glucose.

• Participants asked about fruit juice.
• They asked about yoghurt.
• They asked the questions that people actually ask when they get home.

And that is exactly why these conversations matter.

“You can still do life”

Rufaro shared 22 years of living with Type 1 diabetes.

Rufaro Gororo-Norumedzo| Certified Diabetes Educator

As a mother of four, she spoke about pregnancy, miscarriages, working with healthcare professionals and learning to navigate life with diabetes.

Her message was simple:

You can live a normal and fulfilling life with diabetes.

But she also emphasised the importance of having the right people around you.

Her story was a reminder that behind every diabetes diagnosis is a person with dreams, relationships, responsibilities and a future.

• Diabetes may become part of the story.
• It does not have to become the whole story.

From being afraid to being a pharmacist

Silent Manyere has lived with Type 1 diabetes since 2009.

He spoke about collapsing and being admitted to hospital, but also about what happened outside the hospital.

At school, he kept his diabetes within a small circle of trusted people because he feared stigma.

Later, as he entered the world of work, he experienced another side of stigma — situations where disclosing that he was living with a chronic condition affected employment opportunities.

Today, Silent is a pharmacist and a diabetes educator trainee, under the "Peer-Led Diabetes Empowerment Project"

His message to the room was powerful:

Diabetes should not decide how far you can go.

• You can study.
• You can work.
• You can become a professional.
• You can build a family.
• You can pursue your dreams.

Diabetes has an emotional side too

Clinical Psychologist| Walter Beta

Clinical Psychologist Walter Beta reminded participants that diabetes is not only about insulin and blood glucose.

There is diabetes distress.

There is diabetes burnout.

There is stigma.

There is the emotional burden of making diabetes-related decisions every day.

Sometimes people become tired of constantly having to think about food, insulin, blood glucose, appointments, money, complications and what might happen next.

That does not mean they are weak.

It means they are human.

And sometimes what someone needs is not another instruction.

Sometimes they need someone to listen.

Chivhu was personal for me

Ambassador Tino: Hybrid Closed Looper

I also shared my own experience of living with Type 1 diabetes for 16 years.

Chivhu is particularly personal because it was where I first learnt that something was wrong with my health.

But at the time, the local facilities did not have the resources required to confirm the diagnosis.

I had to be referred to Harare — approximately 190 kilometres away.

Fortunately, I made it.

Standing in Chivhu years later, now as a Certified Diabetes Educator and someone who has spent years advocating for people living with diabetes, was not something I took lightly.

It made the workshop feel personal.

I also spoke about the diabetes technology I have been privileged to access, including continuous glucose monitors and insulin pumps, and my experience using a hybrid closed-loop system since 2024.

I am deeply grateful to friends (that became family) who have helped make this technology accessible to me, including Miroslava Calegari; Nathalie Piat &; Dawn Adams.

But I also wanted participants to understand that technology is not magic.

• Sensors can fail.
• Pumps can have problems.
• Technology can disconnect.

And without the knowledge to use it safely, technology can create new risks.

So the conversation has to be bigger than simply saying, “Diabetes technology is amazing.”

It has to include access, education, safety and support.

The power of bringing everyone together

Perhaps the biggest lesson from Chivhu was what happened when we stopped separating diabetes into different conversations.

1. People living with diabetes brought lived experience.
2. Caregivers brought the realities of home.
3. Healthcare workers brought the challenges they face in the hospital.
4. The clinical team brought medical knowledge.
5. The dietitian brought practical nutrition.
6. The psychologist brought the emotional perspective.
7. And together, the conversation became much bigger than diabetes education.

It became about how we make diabetes care work in real life.

That is what the Peer-Led Diabetes Empowerment Project is trying to build.

We are not trying to replace clinical care.

The healthcare team remains responsible for clinical assessment, diagnosis and treatment.

But people living with diabetes can also bring something valuable to the table — lived experience, practical education, encouragement, peer support and a voice that helps others know they are not alone.

The workshop did not end when everyone went home

One of the things we wanted to establish in Chivhu was that the workshop should not be a once-off event.

Questions do not stop because a workshop has ended.

Someone may remember something when they get home.

• A child may become sick.
• Someone may struggle with insulin.
• A caregiver may have a question.
• A person may simply need someone to talk to.

That is why follow-up pathways were established so participants can continue asking questions, seeking clarification and staying connected to the wider diabetes support network.

For us, that is where the real work begins.

A different kind of health system

The Chivhu workshop left us with a simple thought.

A health system should not only be measured by what happens when someone walks through the hospital doors.

It should also be measured by what happens after they leave.

• Do they understand their condition?
• Do they know where to get help?
• Does their family understand how to support them?
• Does the healthcare worker feel equipped?
• Does the person living with diabetes still have hope?

If the answer to those questions keeps becoming “yes”, then we are moving in the right direction.

We are grateful to the Ministry of Health and Child Care of Zimbabwe for allowing this workshop to take place at Chivhu General Hospital, to Sanofi’s Global Health Unit for powering the Peer-Led Diabetes Empowerment Project, for sustainable impact, and to Lili Grace Foundation Ltd for their continued partnership.

We are equally grateful to the Chivhu General Hospital team, healthcare workers, caregivers, people living with diabetes and every facilitator who made the day what it was.

Because ultimately, diabetes care is not just about numbers.

It is about people.

And when people are given knowledge, support, a voice and someone to walk alongside them, they can do much more than manage diabetes.

They can live.